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Oxycodone interactions with other drugs

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https://www.readbyqxmd.com/read/27555214/effect-of-prolonged-released-oxycodone-naloxone-in-postoperative-pain-management-after-total-knee-replacement-a-nonrandomized-prospective-trial
#1
Johannes Oppermann, Jan Bredow, Christian K Spies, Julia Lemken, Frank Unglaub, Christoph K Boese, Jens Dargel, Peer Eysel, Jan Zöllner
PURPOSE: The purpose of this study was to examine the effect of postoperative prolonged release oxycodone/naloxone (OXN) in comparison to other opioids (control group) on the early postoperative rehabilitation outcome after total knee replacement. METHODS: In a prospective, noninterventional, nonrandomized clinical trial, 80 patients were assigned to either the OXN group or a control group. Postoperative outcome and pain level at days 3, 6, 21, 35, and 6months were evaluated using the Bowel Function Index, Brief Pain Inventory Short Form questionnaire, the Hospital for Special Surgery score, modified Larson score, and the ability to attend physiotherapy...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27378916/pharmacotherapy-of-pain-in-the-older-population-the-place-of-opioids
#2
REVIEW
Milica Prostran, Katarina Savić Vujović, Sonja Vučković, Branislava Medić, Dragana Srebro, Nevena Divac, Radan Stojanović, Aleksandar Vujović, Lepa Jovanović, Ana Jotić, Nataša Cerovac
Pain is a common symptom in older people. It is possible that pain is underreported in older persons due to an incorrect belief that it is an inevitable part of aging. Opioid analgesics are potent medications, with confirmed efficacy for the treatment of moderate to severe pain. These drugs are commonly used in older persons. However, there is insufficient evidence regarding safety of opioids in older patients. One of the reasons for this is the lack of randomized, controlled clinical trials. People of advanced age often have comorbidites and use other prescription drugs, as well as over-the-counter (OTC) compounds, thus making them more suceptible to the risk of interactions with opioids...
2016: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/27227140/direct-to-patient-research-piloting-a-new-approach-to-understanding-drug-safety-during-pregnancy
#3
Nancy A Dreyer, Stella Cf Blackburn, Shahrul Mt-Isa, Jonathan L Richardson, Simon Thomas, Maja Laursen, Priscilla Zetstra-van der Woude, Anna Jamry-Dziurla, Valerie Hliva, Alison Bourke, Lolkje de Jong-van den Berg
BACKGROUND: Little is known about the effects of human fetal exposure when a new drug is authorized unless it was specifically developed for use in pregnancy. Since many factors may contribute to adverse fetal effects, having comprehensive information about in utero exposures will enhance our ability to make correct determinations about causality. OBJECTIVE: The objective of the study was to assess the extent to which women, recruited without the intervention of health care professionals (HCPs), will provide information, suitable for research purposes, via the Internet or by phone on some potential risk factors in pregnancy...
July 2015: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/26921085/drug-interactions-with-aprepitant-or-fosaprepitant-review-of-literature-and-implications-for-clinical-practice
#4
Anna Dushenkov, Julie Kalabalik, Antonia Carbone, Paiboon Jungsuwadee
PURPOSE: Aprepitant and its parenteral formulation fosaprepitant are widely used for the prevention of chemotherapy-induced nausea and vomiting. Aprepitant exerts modest inhibitory effect on CYP3A4 and modest inductive effect on CYP2C9 substrates such as some antineoplastics and multiple other medications. This article is aimed to provide pharmacists and other healthcare professionals with an updated summary of drug-drug interactions of aprepitant/fosaprepitant and implications for clinical practice...
February 25, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/26455893/the-effects-of-pioglitazone-a-ppar%C3%AE-receptor-agonist-on-the-abuse-liability-of-oxycodone-among-nondependent-opioid-users
#5
Jermaine D Jones, Maria A Sullivan, Jeanne M Manubay, Shanthi Mogali, Verena E Metz, Roberto Ciccocioppo, Sandra D Comer
AIMS: Activation of PPARγ by pioglitazone (PIO) has shown some efficacy in attenuating addictive-like responses in laboratory animals. The ability of PIO to alter the effects of opioids in humans has not been characterized in a controlled laboratory setting. The proposed investigation sought to examine the effects of PIO on the subjective, analgesic, physiological and cognitive effects of oxycodone (OXY). METHODS: During this investigation, nondependent prescription opioid abusers (N=17 completers) were maintained for 2-3weeks on ascending daily doses of PIO (0mg, 15mg, 45mg) prior to completing a laboratory session assessing the aforementioned effects of OXY [using a within-session cumulative dosing procedure (0, 10, and 20mg, cumulative dose=30mg)]...
May 15, 2016: Physiology & Behavior
https://www.readbyqxmd.com/read/26300632/is-oxycodone-naloxone-effective-and-safe-in-managing-chronic-pain-of-a-fragile-elderly-patient-with-multiple-skin-ulcers-of-the-lower-limbs-a-case-report
#6
Fabio Guerriero, Niccolo Maurizi, Matthew Francis, Carmelo Sgarlata, Giovanni Ricevuti, Mariangela Rondanelli, Simone Perna, Marco Rollone
Skin ulcers are a common issue in the elderly, as physiological loss of skin elasticity, alterations in microcirculation, and concomitant chronic diseases typically occur in advanced age, thereby predisposing to these painful lesions. Wound-related pain is often associated with skin ulcers and negatively impacts both the patient's quality of life and, indirectly, wound healing. Pain management is an ongoing issue in the elderly, and remains underestimated and under-treated in this fragile population. Recent guidelines suggest the use of opioids as the frontline treatment of moderate and severe pain in nononcological pain in the elderly...
2015: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/26025117/pain-in-the-frail-or-elderly-patient-does-tapentadol-have-a-role
#7
REVIEW
Felicity C Veal, Gregory M Peterson
Persistent pain affects the elderly disproportionally, occurring in 50% of elderly community-dwelling patients and 80% of aged care residents. The management of pain in the elderly and frail patient is complicated because of the risks posed by changes in pharmacokinetics and pharmacodynamics, polypharmacy, and drug-disease interactions. Trials evaluating the efficacy of analgesics have often excluded elderly patients and universally excluded frail patients; therefore, the true efficacy and side-effect profiles in these population groups are largely unknown, especially for long-term use...
June 2015: Drugs & Aging
https://www.readbyqxmd.com/read/25948304/-the-blood-brain-barrier-transport-mechanism-controlling-analgesic-effects-of-opioid-drugs-in-cns
#8
REVIEW
Takashi Okura, Kei Higuchi, Yoshiharu Deguchi
The transport of opioid analgesics across the blood-brain barrier (BBB) is an important determinant of their therapeutic effects. The human brain is protected by the BBB, which consists of brain capillary endothelial cells linked with tight junctions. It is well established that the polarized expression of numerous transporters and receptors at the brain capillary endothelial cells controls the blood-brain exchange of nutrients, waste products deriving from neurotransmitter substances, and drugs. Morphine is a substrate of P-glycoprotein and the P-glycoprotein-mediated efflux transport at the BBB maintains a lower unbound concentration of morphine in the brain compared with plasma...
2015: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/25903219/serotonin-syndrome-probably-triggered-by-a-morphine-phenelzine-interaction
#9
Hector Mateo-Carrasco, Eva María Muñoz-Aguilera, Juan Manuel García-Torrecillas, Hiba Abu Al-Robb
Serotonin syndrome is a potentially life-threatening condition caused by excessive central and peripheral stimulation of serotonin brainstem receptors, usually triggered by inadvertent interactions between agents with serotonergic activity. Evidence supporting an association between nonserotonergic opiates, such as oxycodone or morphine, and serotonin syndrome is very limited and even contradictory. In this case report, we describe a patient who developed serotonergic-adverse effects likely precipitated by an interaction between morphine and phenelzine...
June 2015: Pharmacotherapy
https://www.readbyqxmd.com/read/25868557/azole-antifungal-inhibition-of-buprenorphine-methadone-and-oxycodone-in-vitro-metabolism
#10
COMPARATIVE STUDY
David E Moody, Fenyun Liu, Wenfang B Fang
Opioid-related mortality rates have escalated. Drug interactions may increase blood concentrations of the opioid. We therefore used human liver microsomes (HLMs) and cDNA-expressed human cytochrome P450s (rCYPs) to study in vitro inhibition of buprenorphine metabolism to norbuprenorphine (CYP3A4 and 2C8), oxycodone metabolism to noroxycodone (CYP3A4 and 2C18) and oxymorphone (CYP2D6), and methadone metabolism to R- and S-2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP; CYP3A4 and 2B6). In this study, we have examined the inhibitory effect of 12 (mostly antifungal) azoles...
June 2015: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/25821010/oral-analgesia-for-relieving-post-caesarean-pain
#11
REVIEW
Nondumiso Mkontwana, Natalia Novikova
BACKGROUND: Oral analgesia is a convenient and widely used form of pain relief following caesarean section. It includes various medications used at different doses alone or in adjunction to other form of analgesia. OBJECTIVES: To determine the effectiveness, safety and cost-effectiveness of oral analgesia for post-caesarean pain relief. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014) and reference lists of retrieved studies...
March 29, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25250949/pharmacoepidemiological-assessment-of-drug-interactions-with-vitamin-k-antagonists
#12
Anton Pottegård, Rene dePont Christensen, Shirley V Wang, Joshua J Gagne, Torben B Larsen, Jesper Hallas
PURPOSE: We present a database of prescription drugs and international normalized ratio (INR) data and the applied methodology for its use to assess drug-drug interactions with vitamin K antagonists (VKAs). We use the putative interaction between VKAs and tramadol as a case study. METHODS: We used a self-controlled case series to estimate the incidence rate ratio (IRR) comparing the rate of INR measurements of ≥4.0 in concomitant tramadol and VKA-exposed periods to VKA-only-exposed periods...
November 2014: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/24975450/cyp2d6-inhibiting-drugs-and-the-increased-risk-of-fall-related-injuries-due-to-newly-initiated-opioid-treatment-a-swedish-register-based-case-crossover-study
#13
Jette Möller, Lucie Laflamme, Karin Söderberg Löfdal
It has been shown that newly initiated opioid therapy increases the risk of fall-related injuries. Yet, it remains to be determined whether drug-drug interactions can affect this negative effect, for instance with drugs inhibiting cytochrome P4502D6 (CYP2D6) that metabolizes codeine and also has a partial effect on tramadol and oxycodone. Our aim was to investigate how CYP2D6-inhibiting drugs contribute to explaining the risk of fall-related injuries for newly initiated opioid treatments with codeine, tramadol or oxycodone...
February 2015: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/24802157/urine-specimen-detection-of-zolpidem-use-in-patients-with-pain
#14
Lindsey M Mann, Rabia S Atayee, Brookie M Best, Candis M Morello, Joseph D Ma
This study examined zolpidem and concurrent opioid, benzodiazepine, other central nervous system (CNS) depressants, and alcohol use. Urine specimens were analyzed using liquid chromatography-mass spectrometry (LC-MS/MS). Specimens were tested for zolpidem (n = 71,919) and separated into a provider-reported medication list documenting (n = 5,257) or not documenting zolpidem use (n = 66,662). Zolpidem-positive specimens were further separated into reported and unreported use cohorts. The total number of zolpidem-positive specimens in the reported and unreported use cohorts was 3,391 and 3,190, respectively...
July 2014: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/23136913/update-on-rifampin-rifabutin-and-rifapentine-drug-interactions
#15
Anne M Baciewicz, Cary R Chrisman, Christopher K Finch, Timothy H Self
BACKGROUND: Rifampin is a potent inducer of both cytochrome P-450 oxidative enzymes and the P-glycoprotein transport system. Among numerous well documented, clinically significant interactions, examples include warfarin, oral contraceptives, itraconazole, digoxin, verapamil, simvastatin, and human immunodeficiency virus-related protease inhibitors. Rifabutin reduces serum concentrations of antiretroviral agents, but less so than rifampin. Rifapentine is also an inducer of drug metabolism...
January 2013: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/22747548/non-analgesic-effects-of-opioids-interactions-between-opioids-and-other-drugs
#16
REVIEW
Tarja Heiskanen, Eija Kalso
Opioids are increasingly used to manage not only acute but also chronic pain and heroine addiction. These patients usually receive many other medications that can interfere with the effects of opioids and vice versa. Patients often need combinations of drugs for their pain management, for treating opioid-related adverse effects or for other indications including depression and anxiety. Several antibiotics can also have interactions with opioids. It is important to understand what potential interactions exist between opioids and other drugs...
2012: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/22365897/separate-and-combined-psychopharmacological-effects-of-alprazolam-and-oxycodone-in-healthy-volunteers
#17
RANDOMIZED CONTROLLED TRIAL
James P Zacny, Judith A Paice, Dennis W Coalson
BACKGROUND: There are epidemiological data indicating that medical and/or nonmedical use of prescription opioids oftentimes involves concurrent use of other substances. One of those substances is benzodiazepines. It would be of relevance to characterize the effects of an opioid and a benzodiazepine when taken together to determine if measures related to abuse liability-related effects and psychomotor performance impairment are increased compared to when the drugs are taken alone. METHODS: Twenty volunteers participated in a crossover, randomized, double-blind study in which they received placebo, 0...
August 1, 2012: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/22348413/towards-safer-and-more-predictable-drug-treatment-reflections-from-studies-of-the-first-bcpt-prize-awardee
#18
REVIEW
Pertti J Neuvonen
This MiniReview is a personal recollection of selected research topics, which the author in collaboration with colleagues has studied, aiming to improve the predictability of drug therapy. In early studies, we found bi- and trivalent cations to reduce the absorption of various tetracyclines and fluoroquinolones. Certain antacids elevated the bioavailability of some non-steroidal anti-inflammatory drugs and sulphonylureas. Various brands of phenytoin tablets revealed great differences in their bioavailability, causing clinical consequences...
March 2012: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/21332315/absorption-distribution-metabolism-and-excretion-pharmacogenomics-of-drugs-of-abuse
#19
REVIEW
Markus R Meyer, Hans H Maurer
Pharmacologic and toxic effects of xenobiotics, such as drugs of abuse, depend on the genotype and phenotype of an individual, and conversely on the isoenzymes involved in their metabolism and transport. The current knowledge of such isoenzymes of frequently abused therapeutics such as opioids (oxycodone, hydrocodone, methadone, fentanyl, buprenorphine, tramadol, heroin, morphine and codeine), anesthetics (γ-hydroxybutyric acid, propofol, ketamine and phencyclidine) and cognitive enhancers (methylphenidate and modafinil), and some important plant-derived hallucinogens (lysergide, salvinorin A, psilocybin and psilocin), as well as of nicotine in humans are summarized in this article...
February 2011: Pharmacogenomics
https://www.readbyqxmd.com/read/21142269/effect-of-inhibition-of-cytochrome-p450-enzymes-2d6-and-3a4-on-the-pharmacokinetics-of-intravenous-oxycodone-a-randomized-three-phase-crossover-placebo-controlled-study
#20
RANDOMIZED CONTROLLED TRIAL
Juha Grönlund, Teijo I Saari, Nora M Hagelberg, Pertti J Neuvonen, Kari Laine, Klaus T Olkkola
BACKGROUND AND OBJECTIVE: Oxycodone is a μ-opioid receptor agonist that is mainly metabolized by hepatic cytochrome P450 (CYP) enzymes. Because CYP enzymes can be inhibited by other drugs, the pharmacokinetics of oxycodone are prone to drug interactions. The aim of this study was to determine whether inhibition of CYP2D6 alone by paroxetine or inhibition of both CYP2D6 and CYP3A4 by a combination of paroxetine and itraconazole alters the pharmacokinetics of and pharmacological response to intravenous oxycodone...
2011: Clinical Drug Investigation
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